| NPI | 1538707294 |
|---|---|
| Doing Business As | LAKE OSWEGO MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | DARIOUSH AFSHAR Owner Doctor 503-334-0351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2022-05-11 |